Provider Demographics
NPI:1437691367
Name:GASTROSPA CORP
Entity Type:Organization
Organization Name:GASTROSPA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARTURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-671-8979
Mailing Address - Street 1:1 AVE PALMA REAL
Mailing Address - Street 2:APT 617
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-7201
Mailing Address - Country:US
Mailing Address - Phone:787-640-6682
Mailing Address - Fax:888-506-3713
Practice Address - Street 1:1 AVE PALMA REAL
Practice Address - Street 2:MURANO LUXURY APT 617
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-7201
Practice Address - Country:US
Practice Address - Phone:787-640-6682
Practice Address - Fax:888-506-3713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-09
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15066261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI00581Medicare UPIN